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Noncalcified, Mixed Coronary Plaques Predict CAD Outcome

Mortality rate in nonobstructive coronary artery disease higher for patients with these plaques

MONDAY, Jan. 24 (HealthDay News) -- The presence of noncalcified and mixed coronary plaques in patients with nonobstructive coronary artery disease (CAD) is associated with worse long-term clinical outcomes, independent of other risk factors, according to a study in the January issue of The American Journal of Cardiology.

To investigate the long-term outcomes of patients with nonobstructive CAD on the basis of the presence of coronary plaques, Naser Ahmadi, M.D., from the Harbor UCLA Medical Center in Torrance, Calif., and colleagues studied 1,102 patients with nonobstructive CAD who underwent computed tomographic angiography (CTA). Subjects were followed for a mean of 78 months.

The researchers found that the death rate of patients with nonobstructive CAD was 3.1 percent, but that the rate increased incrementally from calcified plaque at 1.4 percent, to mixed plaque at 3.3 percent, to noncalcified plaque at 9.6 percent. The risk-adjusted hazard ratios of all-cause mortality in subjects with nonobstructive CAD were 7.4 for noncalcified plaques and 3.2 for mixed plaques compared with calcified plaques.

"We have shown that the survival rate of subjects with nonobstructive CAD decreased significantly with the number of diseased coronary arteries. Moreover, the presence of noncalcified and mixed plaque in symptomatic subjects with nonobstructive CAD as detected by CTA adds incremental prognostic value over traditional risk factor assessment and the number of diseased coronary arteries in both genders," the authors write.

A co-author is on the speaker's bureau for General Electric.

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